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Purpose . To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA), ischemia-modified albumin (IMA) and neuromuscular side effects.  Methods . Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups. In Group S, intrathecal anesthesia was administered using levobupivacaine. Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T. Blood samples were obtained before the induction of anesthesia ( t   1 ), 30 min after tourniquet inflation ( t   2 ), immediately before ( t   3 ), and 5 min ( t   4 ), 15 min ( t   5 ), 30 min ( t   6 ), 1 h ( t   7 ), 2 h ( t   8 ), and 6 h ( t   9 ) after tourniquet release.  Results . MDA and IMA levels increased significantly compared with baseline values in Group S at  t   2 – t   9  and  t   2 – t   7 . MDA levels in Group T and Group I were significantly lower than those in Group S at  t   2 – t   8  and  t   2 – t   9 . IMA levels in Group T were significantly lower than those in Group S at  t   2 – t   7 . Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I.  Conclusions . TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion.

The Effects of Spinal, Inhalation, and Total Intravenous Anesthetic Techniques on Ischemia-Reperfusion Injury in Arthroscopic Knee Surgery